Never Say Die: A Future Tense Event

Intro
Steve Coll, president of the New America Foundation, set the stage for the day’s discussion by providing an interdisciplinary and forward-looking framework to consider radical life extension. He highlighted the relevancy of the issue as America is about to move into an election cycle in 2012, where a large portion of the debate will be on fiscal policy and the assumptions of our entitlement system.  Radical life extension forces leaders to rethink the actuarial assumptions that are essential to the nation’s debate, and the purpose of Tuesday’s event was to tease out these challenges and rethink them. Mr. Coll then introduced Ted Fishman, author of China, Inc. andShock of Gray, which discussed the social and political implications of having a large aging population. One significant problem Fishman highlighted was that there might be immortal life, but perhaps not immortal health. Indeed, humans may not get all of the benefits of eternal life all at once.  He also cited many reasons for a longer life such as diet, nutrition, changes in governmental approach to enforcing public health, as well as literacy. Though the title of the event grapples with radical life extension, Mr. Fishman rightly noted that even one or two years in terms of actuarial assumptions make a huge difference as it translates to economic implications for the social budget. Fishman also pointed out that the nature of life has changed from being an on/off switch (in which any slight medical condition or violent catastrophe can kill you) to a dimmer switch (in which people live longer and bear the diseases that would have earlier killed them).

Panel I
Emily Yoffe, columnist for Slate and the Washington Post, introduced the experts on panel I.  Cynthia Kenyon, American Cancer Society Professor at the University of California San Francisco and the Director of Hillblom Center for the Biology of Aging, spoke regarding the real and emerging possibilities of genes that determine life expectancy. In 1993, she discovered that a single gene mutation could double the lifespan of the flat worm c. elegans, and she has since become a leader in longevity research and gene manipulation. Ana Maria Cuervo, Co-Director of the Institute for Aging Research and Professor of Developmental and Molecular Biology at the Albert Einstein College of Medicine, further contributed to the panel by showing the audience how the research of all of the panelists is interconnected. She emphasized that all of them are unified by the idea that aging is a multifaceted concept, and modifying any one particular thing will have complex causal effects for the rest of the cell and the body.  Dr. Cuervo discussed her work, which largely focuses on how the damage and repair mechanisms in the body play an indispensable role in maintaining vitality and functionality in the body.  Such functions are necessary because parts of the cells are damaged after continual use and are recycled on a frequent basis, and understanding these mechanisms that slow down aging will also help prevent the onset of infections and chronic diseases like cancer and Alzheimer’s. Stephen Johnston, Director of the Innovations in Medicine Program of the Biodesign Institute at Arizona State University, brought the notion of infectious diseases to today’s discussion. While humbly keeping in mind that no one can predict the future with complete accuracy, he gave his three-fold vision of how human life extension might develop. Focusing on chronic diseases, Dr. Johnston said that first, we are able to detect chronic diseases early, then the types of treatment will be more targeted, and finally humans will be able to prevent diseases by taking medicine. He also predicted that humans might be able to extend their biological selves and merge with technology and robotics. Aubrey de Grey, Chief Science Officer of the SENS Foundation, discussed the importance of late onset interventions. He tied in smoothly the theme of complexity and interconnectedness. Dr. de Grey reiterated the idea that while aging is an incredibly complex phenomenon, the process of evolution has allowed the body to develop machinery to regulate conditions that do control lifespan. One switch—like the mutation of a gene Dr. Kenyon works with—can turn on complex mechanisms that extend life. All four scientists emphasized that their goal is not to extend old age and illness, but rather to extend functionality and health. 

Panel II
The second panel, moderated by Will Saletan, national correspondent for Slate magazine, shifted the focus from the scientific perspectives of aging to the social and economic perspectives. Ted Fishman, the Author of Shock of Gray, presented a more gray possibility than that proposed by the first panel: Scientists might not first achieve their aims of extending health and might instead prolong illness and frailty. Jason Furman, Deputy Assistant to the President for Economic Policy and Deputy Director of the National Economic Council, shared his views of the socio-economic future for coming generations. Some benefits he saw were that education would be more appealing, since the amount of time to reap benefits and the amount of time to pay debt both increase, and people would be more likely to take on additional careers. Dr. Furman also discussed more fundamental changes:  People may turn more and more to the market to hedge their risks of the financial harms of longer living. Also, as people live longer, inequality will be more aggressively perpetuated. S. Jay Olshansky, professor of epidemiology at the University of Illinois highlighted the difference between health extension and life extension. Dr. Olshansky further emphasized the importance of allocating research to the study of longevity and not only to find cures for chronic diseases. He praised the work of the morning panel in learning to extend health, for if people only find solutions for curing cancer and ignore working on functionality, humans might see a far more fragile state. Lastly, Jason Robert, the Lincoln Professor of Ethics in Biotechnology & Medicine of the Arizona State University, divided humans into two categories: first those who are forced to die against their will and those who are forced to live against their wills.  Dr. Robert contributed new perspectives on the possibility of life extension to transform personal relationships, and concepts like love, equality, and justice. He reminded us that science and policy should develop gradually together, so that any change in one does not leave the other radically unprepared to deal with its consequences.

Participants